title: Frequency of citrus fruit intake is associated with the incidence of cardiovascular disease: the Jichi Medical School cohort study.
abstract: BACKGROUND
  It has been reported that fruit intake protects against cardiovascular disease (CVD). However, most of the relevant studies were conducted in Western countries, and only a few investigated Japanese populations. The present cohort study assessed the effect of citrus fruit intake on the incidence of CVD and its subtypes in a Japanese population.
  
  
  METHODS
  A baseline examination consisting of physical and blood examinations and a self-administered questionnaire was conducted during the period from April 1992 through July 1995. Dietary habits were assessed using a food frequency questionnaire that was divided into 5 categories. Citrus fruit was examined separately due to its frequent consumption by the general Japanese population. Using the Cox proportional hazards model, data from 10,623 participants (4147 men, 6476 women) who had no history of CVD or carcinoma were analyzed to assess the association between frequency of citrus fruit intake and CVD incidence.
  
  
  RESULTS
  Frequent intake of citrus fruit was associated with a lower incidence of CVD: the hazard ratio for almost daily intake versus infrequent intake of citrus fruit was 0.57 (95% confidence interval: 0.33-1.01, P for trend = 0.04) in men and 0.51 (0.29-0.88, P for trend = 0.02) in women. Frequent intake of citrus fruit was also associated with lower incidences of both all stroke and cerebral infarction, but not hemorrhagic stroke or myocardial infarction.
  
  
  CONCLUSIONS
  Frequent intake of citrus fruit may reduce the incidence of CVD, especially cerebral infarction, in men and women.
authors.affiliation: Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Higashi-ku, Hamamatsu, Japan. 98086tm@jichi.ac.jp
authors.forename: Tomoyo
authors.initials: T
authors.lastname: Yamada
authors.forename: Shinya
authors.initials: S
authors.lastname: Hayasaka
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Shibata
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Ojima
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Saegusa
authors.forename: Tadao
authors.initials: T
authors.lastname: Gotoh
authors.forename: Shizukiyo
authors.initials: S
authors.lastname: Ishikawa
authors.forename: Yosikazu
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Kazunori
authors.initials: K
authors.lastname: Kayaba
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002544:Cerebral Infarction / Q000453:epidemiology; D002957:Citrus; D015331:Cohort Studies; D004034:Diet Surveys; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged